Medical Missionaries of Mary The Medical Missionaries of Mary AIDS Education Programme provides counselling, medical care, home-based care, AIDS education and support for children orphaned as a result of AIDS. Peer educators are used - children who are educated about AIDS and HIV and encouraged to raise awareness of the issue with their friends and family. MMM Counselling and Social Services Centre The MMM Counselling and Social Services Centre was established in 1992 in response to a request by the government for the churches to become involved in the fight against HIV/AIDS. The Ethiopian Catholic Church encouraged the involvement of its members, and the Counselling Centre was one of the first organizations in the country to engage in HIV/AIDS prevention and control activities. We began as a referral centre, receiving people from hospitals and other organizations in the city for counselling. Later we realized the need to be more flexible and respond in a broader way to the problems expressed by clients, their families, and the local community. We have an agreement, through the Addis Ababa Archdiocese, with the Addis Ababa SNGOAO and the Bureau of Health. We aim: To integrate the reality of HIV/AIDS into the life of the local community so persons infected and affected can live as healthy lives as possible and remain at home for terminal care when the time comes. To contribute towards the prevention of HIV/AIDS and the stigma and discrimination associated with it. Our major activities include the following: Counselling We provide various types of confidential counselling for people living with HIV and their families. The aim is to help them live positively with the virus, plan for their future, and help stop the spread of HIV. a. Individual: this may be pre-test, post-test, or on-going and helps the person understand the nature of the test and cope with the possible outcomes. b. Group: a forum for sharing experiences in which clients support each other. c. Family: Clients' families learn the facts about HIV, how to support each other and share their HIV status, and how to care for the sick. d. Couple: Partners are encouraged to share their HIV status, discuss safer sex methods, and plan for their family's future.   Social Services Most clients are poor and have a variety of social problems. We give support according to need as determined after an assessment and psychosocial counselling by a social worker. To avoid dependency, the support is meant to be temporary, and includes financial and nutritional support. We also have livelihood promotion activities and vocational training for those able to work to meet their needs.   Medical and Home-Based Care Nurses treat minor health problems for clients and orphans at the Center. Using a holistic approach, nurses and trained community care givers treat people with chronic illnesses at home, and encourage family members and the community to be involved. Care means helping to meet the psychological, social, spiritual, as well as physical needs of clients. We refer patients to other organizations for services as necessary.   Orphan Support Children orphaned by AIDS have many physical and emotional needs. They often care for their parents when they are ill and suffer trauma from this and from their parents' death. They often have a profound sense of loss and abandonment. In addition, they often experience discrimination from the stigma associated with HIV, and various kinds of exploitation. We make arrangements for accommodation with relatives and neighbours, or for support if children are old enough to manage semi-independently. We have a group home for a small number of children for whom relatives cannot be traced, who are awaiting placement, or who need protection from abusive situations. Increasingly, groups and individuals are expressing interest in sponsoring orphaned children. They take care of their material needs, but more importantly, provide adults to whom they can go for psychological support and advice.   HIV/AIDS Education At present there is no known cure or vaccine for HIV, and treatments are unavailable for the vast majority. There are drugs that prevent transmission of the virus from mother to child, and we encourage the greater availability of these. However the main means of preventing transmission in adults is through behaviour change. An important aspect of our work is education of the public about the virus and life skills training, especially for young people. We encourage the formation of Anti-AIDS clubs to follow up the training, so that members can support each other in the positive decisions they make and spread the knowledge to others. We have an activity designed to create more openness and deal with stigma and resulting discrimination in the community. We train motivators from the kebeles, who go house to house to conduct surveys on knowledge, attitudes, and practices, provide basic facts about HIV/AIDS-related issues, encourage positive behaviour change, and a positive attitudes towards those affected.   Community-Based Programs Many factors not directly related to HIV/AIDS also contribute to the problem. We developed an integrated approach and began community-based Programs. One is for children with disabilities and the other is in development in the Counselling Centre vicinity. They have provided entry points for HIV awareness raising and training community workers in home-based care.   Community Development We have worked with the people in local kebeles to develop a better quality of life. Activities have included improving sanitation and waste disposal, help with kitchen and house repairs, and providing training in vocational skills, literacy and leadership.   Community-based Rehabilitation for Children with Disabilities We work in homes to improve the lives of persons with disabilities and their families; to decrease the prevalence and control the effects of disability; to promote social integration of the children and acceptance by society, and work in advocacy and rehabilitation. MMM St Mary's Laboratory Our integrated services for HIV/AIDS include St Mary's Laboratory, in Gulelle Kifle Ketema, which was opened in 2001. It offers the following: HIV Antibody Testing This is a laboratory test used to determine HIV antibody status after adequate counselling.   Counselling We provide confidential individual and couple pre and post test counselling for those who want to learn their HIV antibody status. The aim is to help clients make a free choice to have a test (VCT), prepare for the result, plan for the future, and help stop the spread of HIV.   General Laboratory Services We offer quality lab tests in haematology, serology, bacteriology, parasitology, urinalysis, and biochemistry.   HIV/AIDS Education Education encourages HIV prevention through behaviour change. An important aspect of our work is education of the public about the virus and life skills training, especially for young people. We encourage the formation of Anti-AIDS clubs to follow up the training, so that members can support each other in the positive decisions they make and spread the knowledge to others. We also carry out the house-to-house activity described in the Counselling Centre programs. Other activities Networking We collaborate with other organizations involved in similar activities and are a resource centre for other groups beginning HIV/AIDS-related programs.   Other organizations dealing with similar issues were begun by former MMM Counselling Centre staff or clients. These include the first associations for HIV+ persons and AIDS orphans in the country: Mekdim, Tesfagoh, and Tesfa Birhan. Others are Hope for Children, CHAD-ET, and FIDO.   Funding The Counselling Centre relies on support from donor agencies and individuals both inside and outside Ethiopia. We welcome any support that will raise awareness about the epidemic and help us to assist those in need. We especially encourage the local community to take responsibility for halting the spread of the virus by behaviour change, support and care for those affected, and fighting for their rights.